Midday Meal Research Articles

Effectiveness of Fortified Mid-Day Meal in Reducing Anemia Among School Children in Dhenkanal, Odisha: A Quasi-Experimental Study.

Iron-deficiency anemia among school-aged children is widespread in India. The efficacy of micronutrient and iron fortified school-served meals in reducing iron deficiency anemia has been demonstrated in randomized controlled trials in other parts of the globe. The current study evaluates its effectiveness in real-world Indian settings. Mid-day-Meal (MDM) programme provides free lunch to students of grades 1 to 8 in all public-funded Indian schools. An implementation research project fortified MDM of all public schools of 4 out of 8 sub-districts ("blocks") of Dhenkanal district of Odisha state with fortified rice kernel (FRK). All the schools of the other 4 blocks fortified with micronutrient powders (MNP)-both FRK and MNP containing equal amounts of supplementary iron and other micronutrients. Schools of 4 matched blocks of neighboring nonimplementing Angul district served as control. Cross-sectional representative samples of students were drawn from the 3 arms, before and after intervention (n = 1764 and n = 1640 respectively). Pre-post changes in anemia prevalence and hemoglobin levels were estimated in the sampled children using difference-in-difference analysis after controlling for inter-arm differences in socioeconomic status, and iron and deworming tablet consumptions. Factoring in pre-post changes in control and adjusting for potential confounders, the proportion of children without anemia and mean hemoglobin improved by 1.93 (1.38, 2.24, P < .001) times and 0.24 (-0.03, 0.51, P = .083) g/dL in MNP; and 1.63 (1.18, 2.24, P = .002) times and 0.18 (-0.09, 0.45, P = .198) g/dL in FRK arms. Fortified MDM could effectively improve anemia status among Indian school-aged children under real-world conditions.

Public-Private Partnership For Food Security in India Through PM-Poshan Scheme

Food, water and shelter are the elementary prerequisite for human survival and their well-being. Food provides the necessary nutrients to fuel the body’s functions; access to adequate quantity of safe and nutritious food is a fundamental human right. However, India still faces challenges in ensuring food security for all its citizens leading to malnutrition, dehydration, and various health issues. Food security in India is a crucial issue that affects millions of people, particularly those living in poverty. The Government has implemented various measures to address this issue, including enactment of the National Food Security Act 2013. Pradhan Mantri Poshan Shakti Nirman (PM-Poshan) earlier known as Mid-Day Meal Scheme is a great measure to tackle the problem of malnutrition among children. The program is based on a multi-sectoral approach involving the health, nutrition and sanitation sectors through community-based monitoring and behaviour change communication. The Government has allocated significant funds for the program and has also partnered with various stakeholders through public-private partnership model (PPPs). Still, there are significant gaps and loopholes in the implementation of these policies. This article brings out the intermediatory role of Akshaya Patra under the PPP Model to overcome the emerging challenges towards the implementation of this scheme.

Effectiveness of nutrition education in enhancing knowledge and attitude of pupils on choice of school mid-day meal in Ibadan, Nigeria.

Children's food choices affect their nutritional health, development, and well-being. In Nigeria, school lunch is generally unregulated; the food menu is usually at the discretion of individual vendors forcing pupils to make unsupervised food choices. This study examined the effectiveness of 6-week nutrition education in enhancing pupils' knowledge and attitude on the school mid-day meal choices in Ibadan, Nigeria. A pre-test/post-test, quasi-experimental study was conducted with 100 pupils in 4th and 5th grades in public primary schools. Multistage sampling was used to select the participants. A nutrition education module and a questionnaire were used to collect the data. Frequency counts and t-test were used for statistical analysis. Findings revealed the following dietary pattern: 44 of the pupils preferred junk food (mean 41.5, SD = 12.9), 37 were inclined toward protein-rich food (mean 37.7, SD = 12.5), 32 favored food items dense in carbohydrates (mean 34.4, SD = 9.5), and 11 showed a preference toward food with high vitamins and minerals (mean 28.4, SD = 7.5). Nutrition knowledge (t = 6.4, df = 99, p < .05); (pre-test: = 20.9 and SD = 1.0; post-test: = 22.8, SD = 2.8) and attitude toward choice of meal showed statistically significant differences (t = 4.9, df = 99, p < .05; pre-test: = 13.5 and SD = 6.8; post-test: = 18.2, SD = 7.2). We recommend that the Ministry of Education should prepare a standard lunch menu for all schools and the school authorities should enforce it through the schools' food vendors.

Feasibility of Cassava Semolina (Attiéké) as a Vehicle for Food Fortification: A Survey in Areas of Côte d'Ivoire with High Levels of Childhood Micronutrient Deficiencies

Aims: This study constitutes the first approach to a food program. It was carried out in order to make up a useful database for a nutritional intervention by evaluating the level and practices of consumption of cassava semolina (Attiéké) among school children in rural communities.&#x0D; Study Design: This study was conducted from May 14 to 21, 2021 in elementary school in six villages in an area of Côte d'Ivoire that previously had a high incidence of childhood anemia.&#x0D; Methods: A cross-sectional survey collected data from first- to sixth-grade school children and aged from five to fifteen years (n = 460). Children provided data on their cassava semolina consumption in response to individual structured interviews conducted in their elementary schools and in the presence of one of their parents.&#x0D; Results: The results suggest that cassava semolina is an accessible, familiar and acceptable vehicle for food fortification to overcome nutritional deficits in children in this area. Cassava semolina is available throughout the year in this area. Children consumed an average of 95.5 g/day of cassava semolina and over three quarters of them (88.5%) had consumed this food on at least one day during the week prior to the survey. Cassava semolina was most often eaten for the midday meal (77.2%) in combination with fish (86.3%) and/or vegetables (79.1%). Finally, although cassava can be grown in this area, most children’s families (75.9%) purchased processed cassava semolina.&#x0D; Conclusion: The fortification of semolina would have high penetration in the population. However, the survey also identified a major challenge to using cassava semolina as a vehicle for micronutrient fortification. This is the shelf life of fresh cassava semolina, which is only 3 to 4 days in the absence of refrigeration.

An appraisal of the implementation of the national school feeding programme and its effect on enrolment and attendance in public primary schools in Southeast, Nigeria: perception of heads of schools

IntroductionThe National Home Grown School Feeding Programme (NHGSFP) was re-launched in Nigeria in 2016, eleven years after it was first introduced in the country, with Enugu as one of the beneficiary States. The objectives of the programme are to improve the health of school children and aid in the realization of Universal Basic Education (UBE) goals. This study explored the opinions of heads of public primary schools on the implementation and policy benefits of NHGSFP in Enugu, southeast Nigeria.MethodsThis was a cross-sectional study conducted among 24 headmasters and headmistresses purposively selected from public primary schools in the Enugu metropolis. Qualitative data were collected through the use of a pretested Key Informant Interview (KII) guide, and analyzed using a thematic approach.ResultsAll the participants were aware of the NHGSFP, which involved the provision of one mid-day meal per child per school day to the pupils, and all their schools were part of the programme. Most of the participants complained about the nutritional quality and quantity of the school meals which they felt were poor. None of the schools had a kitchen within the school premises, and all the participants admitted that deworming was not regularly carried out, as part of the programme. Most of the participants believed that the objectives of the feeding programme, including, reduced hunger among learners, increased school enrolment, attendance and enhanced participatory learning, were being met.ConclusionAlthough the NHGSFP was implemented in every school in Enugu metropolis, Enugu State, Nigeria, regular deworming of pupils was not carried out, and there were concerns about certain aspects of the implementation, such as inadequate funding and poor quality of school meals. Thus, there is a need for the introduction of deworming and more allocation of funds to the programme to improve the quantity and nutritional quality of school meals.

Delaying the Introduction of Complementary Food until 6 Months does not Affect Appetite or Mother's Report of Food Acceptance of Breast-Fed Infants from 6 to 12 Months in a Low Income, Honduran Population

Low income, primiparous mothers who had exclusively breast-fed for 4 mo were randomly assigned to one of three groups: 1) continued exclusive breast-feeding to 6 mo (EBF), 2) introduction of complementary foods at 4 mo, with ad libitum nursing 4–6 mo (SF), and 3) introduction of complementary foods at 4 mo, with maintenance of base-line nursing frequency 4–6 mo (SF-M). After the intervention phase (4–6 mo; n = 141), home visits were conducted for a subsample at 9 (n = 60) and 12 (n = 123) mo. At each visit, an observer recorded infant food intake at the midday meal and interviewed the mother regarding usual feeding patterns and the infant's acceptance of 20 common food items. All but two infants (1.5%) were breast-fed to 9 mo and all but eight (6%) to 12 mo. There were no significant differences among groups in breast-feeding frequency, amount or number of foods consumed at the midday meal, percentage of food offered that was consumed, usual daily number of meals and snacks, number of food groups consumed, or overall food acceptance score. Frequency of consumption of foods from eight different food groups (dairy, meats, eggs, grains, beans, fruits, vegetables, tubers) was not significantly different among groups except that, at 9 mo only, the SF group (but not the SF-M group) consumed more vegetables than did the EBF group. These results indicate that delaying the introduction of complementary foods until 6 mo does not adversely affect appetite or food acceptance among breast-fed infants.

The Reproduction of Urban Capitalism: Street Food and the Working Day in Colonial Mombasa

AbstractThis article argues that street food was an essential part of the social reproduction of Mombasa's working class during the colonial period. Like in other expanding capitalist cities, as Mombasa grew, urban workers lived further from their place of employment, which meant they could not return home for their midday meal. Street-food vendors provided them lunch at low prices in convenient locations, and therefore reproduced the working day by provisioning the calories that bridged morning to afternoon. However, postwar municipal authorities also wanted to create a particular kind of urban society in which the ‘informal’ activities of street-food vendors did not fit, and tried to expel them from the city's streets. As these campaigns unfolded, an unresolved contradiction emerged between this elite view of Mombasa, and the reality that the services vendors provided were necessary for the reproduction of the city's economy.

Active Feeding Behavior Compensates for Low Interest in Food among Young Nicaraguan Children

The association of caregivers' feeding behavior with young children's anthropometric status was examined in 80 poor urban families from Nicaragua. Caregiver and child behaviors observed during eating were recorded for midday meals, snacks and bottle feeds. Two kinds of scales were constructed. The Active Feeding Scale measured the caregiver's attempts to encourage or promote the child's food ingestion through behaviors such as verbal encouragement, threatening, offering more food or demonstrating eating. The Child Demand Scale measured the child's interest and enthusiasm for food. Results suggested the following: 1) there were significant differences in caregiver encouragement of feeding by meal type (midday meal, snack or bottle-feed); 2) mothers were significantly more likely to encourage eating than were other caregivers; and 3) active feeding was not associated with child anthropometric status but often appeared to be associated with child disinterest in the meal. It is suggested that active feeding may be used to compensate for child disinterest in food rather than to enhance the child's growth and developmental trajectory. The importance of lack of child interest in food, probably related to poor appetite, needs to be recognized and incorporated into nutrition education programs.

Review of blood donor deferral with emphasis on donor and patient safety.

Blood donor deferral is a part and parcel of the commitment of the blood transfusion services to assure the safety and health of the blood donor as well as the recipient. Periodic review of blood donor deferral is to incorporate or revoke deferral reasons based on the evidence generated in the process of review. Therefore, emphasis must be laid on preparing strategies to only judiciously defer blood donors, recruit and retain first time blood donors, which needs critical appraisal of the existing deferral policies, so that the evidence based changes can be done. A retrospective analysis of deferral in blood donors who presented at the blood donation centre of an institute of national importance over a span of nine years (2011-2019). Donors were screened as per the Drugs and Cosmetics Act 1940 and Rules 1945 given by the Ministry of Health and Family Welfare, Govt of India. There were 1,37,935 donors attempts, out of which 20,167 (14.6%) donors were deferred from donating blood. Most of the deferred donors were male (88.5%), first time (86.1%) and temporarily deferred (87.6%). Almost comparable number of donors (49.1 % & 48.5%) were deferred for donor safety and patient safety reasons respectively. Overall the three most common reasons for deferral were low hemoglobin (21.6%), hypertension (11.4%) and history of jaundice (9%). In donor safety reasons, low hemoglobin (43.4%), hypertension (22.9%) and low blood pressure (4.5%), and in patient safety, a history of jaundice (18.6%), common cold (15.8%), and high-risk behavior (8.8%) emerged as the three most common reasons for deferral respectively. Blood donor deferral is an essential quality indicator of the blood donor selection process. Initiatives like fortification of dietary ingredients with iron, optimizing protein in diet served in schools under mid-day meal program, screening for iron deficiency, hypertension and education about high-risk behavior in schools and colleges may have long term effects of promotion of better health.

Field-friendly MUNNG® optima simple test kit for quick qualitative assessment of iodine and iron presence in double-fortified salt.

Data from several efficacy studies and a long-term effectiveness study have encouraged the governments to adopt a policy of providing double-fortified salt (DFS) in the Mid-Day Meal (MDM) programs in government schools across India. These envisaged food security events are likely to boost the manufacturing of DFS in a big way. Thus, it becomes pertinent to come up with a robust monitoring system involving community and field workers for quality checks. It is imperative to equip these field workers with simple testing kits (STKs) capable of qualitative detection of iron and iodine in DFS. As the consumer acceptance of foods is based on several factors including sensory characteristics, performance, convenience, cost, nutrition, and product image, a variety of iron compounds are in use for fortification. However, it becomes challenging to provide a kit that can overcome the chemical masking of iodine detection by iron compounds. We aimed at (1) the development of a field-friendly STK for quick qualitative assessment of iodine and various forms of iron present in DFS, (2) to check its validity under field conditions. We put in place reagents combined using known chemical reactions and balanced use of oxidants to overcome the problems of encapsulation and to maximize the use, by enabling reagent combination to react with all forms of iron. The kit reagents successfully detect iodine as well as three commonly used iron fortificants in DFS. Published field trials confirmed the specificity and sensitivity of the developed kit. The simplicity and use of the kit by a field worker can be seen in the enclosed video. The combination of improvised kit reagents allows early detection of iron and iodine in DFS. Iron is detected in a variety of iron-containing fortifications. The provision of diluted H2O2 ensures the presence of oxygen-free radicals that enhances iodine release captured by concentrated KI making iodine detection an easy task.

A Simplified Low-Dose 10-Day Quadruple Therapy with a Galenic Formulation of Bismuth Salicylate Is Highly Effective for Helicobacter pylori Eradication.

Earlier studies have shown that a modified low-dose bismuth quadruple therapy given for 10 to 14 days is highly effective for the treatment of Helicobacter pylori infection in Sardinia. However, bismuth is not universally available. We aimed to investigate the efficacy of a simplified low-dose 10-day quadruple therapy containing a galenic formulation of bismuth salicylate for H. pylori infection. Adult patients positive for H. pylori infection were assigned to a quadruple therapy containing a galenic formulation of bismuth salicylate (200 mg) plus tetracycline 500 mg, metronidazole 500 mg and rabeprazole 20 mg, given twice a day with the midday and evening meals for 10 days. A negative stool antigen test or 13C-Urea Breath Test defined successful eradication. Compliance and adverse events were recorded 30-40 days after the end of treatment. In this open-label pilot study, 42 patients were enrolled (mean age 54.1 ± 12.0 years; 64% female). Among the study participants, 35 were naïve to H. pylori treatment. The treatment regimen was completed by 41 patients, with an overall success rate of 95.1%. More specifically, the eradication rate was 95.1% PP; 95% confidence interval (CI) = 86.6-100 and 92.9% by ITT; 95%CI = 85.1-100%, respectively. For naïve patients, the cure rate was 97.1%. Compliance was excellent. Side effects were absent or mild overall. The modified low-dose 10-day quadruple therapy provided high eradication rates of H. pylori infection, despite the replacement of colloidal bismuth subcitrate with bismuth salicylate. In regions where bismuth is unavailable in the market, the galenic formulation should be a valid option.

Many aspects of the mid-day meal: An evaluation of its implementation and challenges

Mid-day meal scheme is one of the most comprehensive schemes as it includes measures for catering to dropouts, increasing retention in the school, popularizing education among the disadvantaged, and considering the socio-economic conditions of the large population into focus. The paper aims to overview what the program calls for, discussing its various versions and popular practices of each state, therefore looking for its implementation on the ground, going through the challenges along the way, and finally, it presents some highlights and suggestions which can be considered.

India's tryst with salt: Dandi march to low sodium salts.

Salt plays a critical role in India's past as well as its present, from Dandi March to its role as a vehicle for micronutrient fortification. However, excess salt intake is a risk factor for high blood pressure and cardiovascular diseases (CVDs). Indians consume double the World Health Organization recommended daily salt (<5 g). India has committed to a 30 per cent reduction in sodium intake by 2025. Evidence based strategies for population sodium intake reduction require a moderate reduction in salt in - home cooked foods, packaged foods and outside-home foods. Reducing the sodium content in packaged food includes policy driven interventions such as front-of-package warning labels, food reformulation, marketing restrictions and taxation on high sodium foods. For foods outside of the home, setting standards for foods purchased and served by schemes like mid-day meals can have a moderate impact. For home cooked foods (the major source of sodium), strategies include advocacy for reducing salt intake. In addition to mass media campaigns for awareness generation, substituting regular salt with low sodium salt (LSS) has the potential to reduce salt intake even in the absence of a major shift in consumer behaviour. LSS substitution effectively lowers blood pressure and thus reduces the risk of CVDs. Further research is required on the effect of LSS substitutes on patients with chronic kidney disease. India needs an integrated approach to sodium reduction that uses evidence based strategies and can be implemented sustainably at scale. This will be possible only through scientific research, governmental leadership and a responsive evidence-to-action approach through a multi-stakeholder coalition.

Некоторые аспекты формирования рационов питания детей разных возрастных групп

Aim: to analyze the frequency of eating and the range of products used as snacks and to assess the impact of snacking on the digestive tract of children of different ages. Patients and Methods: a questionnaire survey of 2250 parents of preschoolers (3-6 years old) and 2250 parents of schoolchildren in Saratov city and Saratov region was conducted. Outpatient medical records of 4500 children were analyzed to assess the findings of physical exam performed by gastroenterologist, child's life and medical history, and the results of laboratory and instrumental tests used for evaluating the gastrointestinal system. Results: an adequate dietary pattern (breakfast, second breakfast, lunch, midday meal, dinner) was followed by 64% of preschoolers and 36% of schoolchildren (р&lt;0.05). The majority of preschool- and school-aged children missed the second breakfast. Most of them — 90% of preschoolers and 78% of schoolchildren had snacks 1–3 times a day. Most commonly both preschool- and school-aged children were eating sausage snacks: 35% and 40% of the interviewed individuals, respectively. Fruits (32%) and confectionery products (22%) were the second most popular snacks among the preschool- and school-aged children. Every 5th preschooler and every 3rd schoolchild consumed sausage products weekly. Children who were snacking with sweets and eating sausages daily had more gastrointestinal complaints and more frequently required regular medical check-ups (registered with Group “D”) by gastroenterologist with the diagnoses of gastritis, gastroduodenitis, biliary dyskinesia, and chronic constipation, and this difference was statistically significant. Conclusion: preschool- and school-aged children most commonly get sausage and confectionary products as additional meals which may cause multiple health problems in the future. For the rational development of additional diets for children of different ages it is necessary to regulate such meals and to introduce consensus documents on the rate of consumption and the optimal formulations of food products used as snacks. KEYWORDS: schoolchildren, preschoolers, snacking, nutrition, gastrointestinal disorders. FOR CITATION: Chernenkov Yu.V., Gumenyuk O.I., Glushakov I.A., Glushakova V.D. Some aspects of developing diets for children of different age groups. Russian Journal of Woman and Child Health. 2023;6(2):169–174 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-169-174.

IMPACT OF MID-DAY MEAL PROGRAMME ON PRIMARY SCHOOL LEVEL: A CASE STUDY OF BOKARO DISTRICT IN JHARKHAND

The main purpose of the present study was to study the mid-day meal and quality in primary education. The study was conducted on a sample of 15 Head master/Principal and 90 teachers of schools from Bokaro district. A standardized questionnaire made by the investigator was used to collect data. Primary and secondary data were used for the study. The study indicates that mid-day meal has a great impact on improving quality of primary education. It helps in enrollment of the students. MDMS also increased the attendance of the students

Assessing Incentives of Workers of Private and Public High Schools in Sunyani Municipality, Ghana

Available and preferred incentives of staff members of five public and five private Senior High schools in Sunyani Municipality, Ghana, West Africa, were compared in this study during the 2021/2022 academic year. A random sample of 214 out of 645 workers from the 10 schools selected from 19 responded to 55 Likert-type questionnaires which had been pretested and with the Cronbach score of 0.73. Inferential statistical analysis identified several and specific incentives offered to the two groups (private and public), as well as those they prefer. Respondents from private institutions favoured incentives that emphasized on their development to enhance their ability to excel and to support their remunerations with mid-day meals. However, public sector workers prioritized facilities like school busing, small classroom sizes, and improved retirement benefits. The revelation from the study suggests the need for educational institutions to continuously track workers' performance against the incentives and rewards granted. Public workers are remunerated from the public trust and assured of timely payments and promotions, but not necessarily satisfied. Future studies will need to assess the level of satisfaction against the performance of their schools.

The Function of Mid-day Meal Scheme: A Critical Analysis of Existing Policies and Procedures in Rayagada District of Odisha (India)

The Government of India initiated the second-largest food security programme, named the mid-day meal (MDM) Scheme to tackle nutrition-related issues, especially for children in backward communities. The main aim of the MDM Scheme in government and government-aided schools is to improve physical and economic access to nutritious food for children. The study evaluates the challenges regarding the existing practices in implementing the MDM Scheme in two blocks of the Rayagada district (Odisha, India). Rayagada district is one of the tribal districts with a high malnutrition condition among children. Further, the two blocks have been selected based on the implementation of MDM on a unique project basis in a resource crunch area. The study shows that the MDM Scheme has challenges with critical implementation issues such as delays in delivery, low-quality food, lack of water facilities and unhygienic cooking and serving practices. The findings have implications for effective implementation of the programme in similar contexts.

Contribution of Mid-Day Meal Scheme in Increasing Enrolment and Retention in Schools: A Study in Nayapalli Region of Bhubaneswar

Contribution of Mid-Day Meal Scheme in Increasing Enrolment and Retention in Schools: A Study in Nayapalli Region of Bhubaneswar

Nutritional Status of Children Among the Age Group of 3-5-Year-Old in the Urban Slums of Delhi

Background - In India, 14% of the population is undernourished, according to 'The State of Food Security and Nutrition in the World, 2020 report. Further, the Covid-19 situation has increased the risk of a child’s nutrition. With the disruption of Anganwadi services and the Mid-Day Meal (MDM)service delivery system, a large number of children don’t have access to regular, nutritious meals. The overburdening of health systems has impaired service delivery of captious health and nutrition interventions for children. Subsequently, the economic impact of the pandemic has reduced the frequency and quality of meals consumed by households. Methodology- A cross-sectional study is conducted in the slums of the southern region of Delhi involving the children of the age group of 3-5-year-old. Multistage random sampling is done where sampling size is calculated according to the prevalence of malnutrition of 20%. Calculated by formula 4PQ/L2 P=prevalence of malnutrition (taking like 20%), Q= 100-P, L= Allowable error (5%)=4*20*80/5*5=256 children. Inclusion criteria for the children are those who are within the age group of 3-5-year-old and are present at the time of the household visit and are not seriously ill. Exclusion criteria for the children are those who are below 3 years of age and the children with chronic morbidity and suffering from a serious illness. Those families not giving consent. Children in the age group of more than 5 years. Children having cerebral palsy, congenital malformation, HIV infection or any other excluded. Result - Malnutrition is highly prevalent in the study population of the urban slums of Delhi. In the form of both acute and chronic malnutrition. Out of 256 children, 34 per cent of the children are severely underweight, 16 percentage of the children are severely stunted and 24.6 percentage of the children are severely acutely malnourished. 21.1 percentage of the children come in the category of moderately underweight,28.1 percentage of the children comes in the category of stunted,30.5 percentage of the children comes in the category of moderately acute malnourished. Keywords: Malnutrition, Nutritional status of children, urban slums of Delhi

IMPACT OF MID-DAY MEAL PROGRAMME ON THE NUTRITIONAL STATUS OF PRIMARY SCHOOL CHILDREN

Children have the right to get the primary education, as stated in the Indian Constitution. The government has proposed an amendment to allow as children between the ages of 6 and 12 to get free and compulsory education. The Government of India has launched a multifaceted programme called the Mid-Day Meal Scheme. It addresses difficulties with access to education, inadequate nutrition, and food security. The population in this particular research study includes all children aged 6–11 and studying in Primary Schools of Utter Pradesh. 509 subjects were chosen. 263 boys and 246 girls were selected through random sampling. According to the Waterlow Classification, children are more wasted, stunted and wasted and stunted than normal students in physical health. Waterlow Classification indicates low levels of physical health of primary school children. The average weight of urban boys and girls was more than the rural boys and rural girls. The overall height of all boys and girls is considered below ICMR standards of height. There was found a significant difference in height and weight between boys and girls of urban and rural areas.